- Stony Brook University (Commack, NY)
- …Stony Brook Clinical Practice Management Plan, Inc., and Meeting House Lane Medical Practice, PC._ **Duties of a Managed Care Provider Enrollment Specialist may ... Such as, but are not limited to, the following: Claim denials; Authorization issues; Provider participation inquiries; Transferring of member panel inquiries; and… more
- Highland Hospital (Rochester, NY)
- …. Compassionate communication and professionalism are essential in supporting patients and families. Prior experience in a medical office and comfort with EPIC ... 16774BR **Job Requirements:** 1. Education: AAS or diploma or certificate in Medical Secretary Science; or equivalent experience required. 2. Experience: 2-3 years… more
- Humana (Albany, NY)
- …management ( Medical Director, clinician decision making teams, quality audits, prior authorization list and clinical policy) as well as enterprise ... years + experience working with CMS Compliance Regulations + Experience working with medical directors in some capacity ie Committees, projects. + 3 or more years'… more
- Publicis Groupe (New York, NY)
- …loading authorized buys in Prisma + Generate paperwork necessary for purchase authorization and ensure vendor counter signature is received + Primary party ... Primary party responsible for QA of all campaign components prior to launch + Monitor and maintain campaign budgets,...person to grow and thrive. Our benefits package includes medical coverage, dental, vision, disability, 401K, as well as… more
- Humana (Albany, NY)
- …medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization . This role involves evaluating complex clinical ... comprehensive reviews of medication care plans. This includes evaluating medical necessity, analyzing overall utilization, and identifying unusual usage patterns.… more
- Humana (Albany, NY)
- …ICD-10 codes. + Member service + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care organization. **Additional ... orders and arrange a safe facility discharge. + Work with UM Nurses, Pharmacy, Medical Directors and other Departments. + During downtime make calls to UM Nurses,… more
- RTX Corporation (Bohemia, NY)
- …sponsorship for this position. The company will not seek an export authorization for this role. **Security Clearance:** None/Not Required This position Is for ... Typically requires a University Degree and minimum 5 years prior relevant experience or an Advanced Degree in a...Offer** Some of our competitive benefits package includes: + Medical , dental, and vision insurance + Three weeks of… more
- Spectrum Health and Human Services (Buffalo, NY)
- …treatment, rehabilitative, and support services matters (eg, AOT, Social Security applications, prior authorization of mediation, etc.). + Participate in and ... and staff delivery of clinical services; the PMHNP provides psychiatric and medical assessment and treatment; clinical supervision, education, and training of the… more
- University of Rochester (Rochester, NY)
- …cases. + Works with denials for surgeries to obtain documentation to for authorization , manages a high level of faxed referrals, uses independent judgement when ... slides are sent to URMC, outside images are uploaded prior to the new patient appointment. + Performs duties...+ High School Diploma Required + Associates degree in Medical , Secretarial or related field Preferred + 2 years… more
- Oak Orchard Health (Steuben County, NY)
- …needed for Providers/patients. + Initiates and completes all parts of medication prior - authorization requests based on insurance requirements. + Perform family ... as a member of the Clinical Care Team, assisting medical providers in direct patient care and maintaining processes...processes that result in efficient, high quality nursing and medical care. Job Responsibilities: + Maintains patient flow by… more